While South Africa’s government healthcare has been exemplary and a model to countries all over the world since its inception; due to limited specialised facilities and long waiting periods caused by the growing need for government healthcare, the simultaneously developing private healthcare was regarded as preferable to those with better financial means.
1960s – The emergence of hospital insurance
In the 1960s, insurance companies saw business opportunities and their product offerings soon included private hospital insurance. This type of cover consisted of a fixed amount for each day of hospitalisation, but excluded costs related to treatment and the use of the hospital facilities. Most medical insurance companies today still offer very similar, limited cover.
1980s – More comprehensive product offerings
Only in the 1980s did more specialised funds to cover healthcare start to emerge and while these schemes were very similar to the hospital insurance companies, they had a better understanding of how medical service providers operated and a better insight into patient requirements, which enabled them to develop increasingly comprehensive, more suitable products. The medical insurance industry was still mainly operating commercially, however, and was still unregulated.
1998 – The formation of the Council for Medical Schemes and PMBs
The late 1990s saw the formation of the Council for Medical Schemes by the Department of Health to regulate member benefits and premiums as well as to arbitrate member complaints. The Prescribed Minimum Benefits Act, mandating full medical cover for the treatment of 26 chronic conditions, was one of the most significant contributions to the welfare of South Africans since the 1960s. Conditions such as epilepsy, cardiac failure, diabetes and multiple sclerosis are among the many chronic conditions in this act, making it compulsory for medical aid schemes to provide their members with full cover.
Medical aid schemes today
The medical aid schemes in South Africa today are divided between restricted medical- and open medical schemes. The restricted schemes are for people in specific industries, employed by a certain company, belong to certain associations or who have a specific academic qualification. Open medical aid schemes are available to all South Africans, provided they are able to pay for the membership. There are approximately 70 restricted medical aid schemes in South Africa and approximately 27 open medical schemes.
Medical schemes offer various types of cover, depending on the member’s individual needs, ranging from fully comprehensive plans to basic cover and hospital plans. Joining a medical scheme means ensuring access to the best possible medical care for you and your dependants.
Resolution Health is one of South Africa’s 10 largest open medical schemes providing members with a range of medical cover from the elementary to the more comprehensive benefit structures. With a holistic approach to medical aid, Resolution Health ensures that members have access to the benefits they need, when they need them, with tailored-made health-care options to suit their specific needs.